versão On-line ISSN 1683-9803

Resumo

Objectives: To analyze the demographic, clinical and laboratory characteristics of patients hospitalized in the pediatrics ward of the Hospital de Clínicas with a diagnosis of visceral leishmaniasis and describe their treatment and progression. Materials and Methods: A retrospective, descriptive and cross-sectional study. Those included were children under age 15 years admitted to the pediatric ward of the Hospital de Clínicas, FCM-UNA, from January 2002 to December 2007 and who were diagnosed with visceral leishmaniasis according to clinical signs, rK39 serology, and direct visualization of the parasite in bone marrow smear and culture. NHSC tables were consulted for evaluation of nutritional status. Results: The study included 42 patients with a mean age of 2.4 years and standard deviation (SD) of 2.4 years, while 19 patients (45.2%) were female and 23 male (54.8%). 33 (79%) were from the Asuncion area and 9 (21%) from other areas of the country. Principle symptoms were fever in 37 patients (88%), pallor in 33 (79%), and enlarged abdominal organs in 25 (60%). Clinical examination found 42 patients (100%) with hepatomegaly and splenomegaly. On average patient livers measured 6 cm with a SD of 3 (range: 2 to 13) while spleens averaged 8 cm with a SD of 4 (range 1 to 20). Anemia was found in all 42 patients (100%), with average hemoglobin of 6.7 g/dl and SD 1.2 (range 4.3 to 10). Thrombocytopenia was found in 27 patients (64.3%) and leukopenia in 33 (78.6%). Some degree of malnutrition was found in 28 patients (67%), of whom 14 (24%) had Grade 3 malnutrition. Treatment of choice was Glucantime® (N-Methylglucamine antimonate), used in 37 patients (88%), while amphotericin B was used in 5 patients (12%). Outcome was good in 39 patients (93%), while 3 patients (7%) died during hospitalization. Conclusions: Visceral Leishmaniasis is endemic in Paraguay and mainly affects young children. It is distributed mainly in urban and semi-urban areas, where dogs are the main reservoir.